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dc.contributor.authorMinoura, Takaakien
dc.contributor.authorTakeuchi, Masatoen
dc.contributor.authorMorita, Tatsuyaen
dc.contributor.authorKawakami, Kojien
dc.contributor.alternative箕浦, 孝晃ja
dc.contributor.alternative竹内, 正人ja
dc.contributor.alternative川上, 浩司ja
dc.description.abstractContext: Malignant bowel obstruction impairs the quality of life in patients with advanced cancer. Octreotide, acid-suppressing medications such as H₂-receptor antagonists (H₂-blockers) and proton pump inhibitors (PPIs), and corticosteroids are often used in combination for symptom control. Objectives: We evaluated the practice patterns of medications for patients hospitalized with malignant bowel obstruction using a large claims database in Japan. In addition, we explored the association of adding H₂-blockers/PPIs or corticosteroids to octreotide on treatment outcomes. Methods: We analyzed data from a nationwide medical claims database from April 2010 to March 2015 containing 975, 000 patients. We included all adult inpatients with cancer who used octreotide 300 μg/day or more and summarized each patient's medication use. We also assessed whether concomitant use of H₂-blockers/PPIs or corticosteroids was associated with the number of days of nasogastric tube (NGT) insertion; logistic regression was used to adjust the patients' baseline factors. Results: We included 3090 patients; octreotide alone was used in 1649 (53%) cases. A combination of octreotide and H₂-blockers or PPIs was used in 419 and 337 cases (14% and 11%), respectively; a combination of octreotide and corticosteroids was used in 374 cases (12%). Of the 1595 patients who underwent NGT insertion, those using corticosteroids with octreotide had a higher odds ratio of NGT removal within four days of insertion (adjusted odds ratio = 1.16; 95% CI = 1.08–1.23). Conclusion: Octreotide alone was used in the majority of patients, and the concomitant use of corticosteroids was more likely to be associated with early NGT removal.en
dc.publisherElsevier BVen
dc.rights© 2018. This manuscript version is made available under the CC-BY-NC-ND 4.0 license
dc.rightsThis is not the published version. Please cite only the published version.en
dc.subjectMalignant bowel obstructionen
dc.subjectclaims databaseen
dc.subjectpalliative careen
dc.subjectconcomitant drugsen
dc.titlePractice Patterns of Medications for Patients With Malignant Bowel Obstruction Using a Nationwide Claims Database and the Association Between Treatment Outcomes and Concomitant Use of H₂-Blockers/Proton Pump Inhibitors and Corticosteroids With Octreotideen
dc.typejournal article-
dc.type.niitypeJournal Article-
dc.identifier.jtitleJournal of pain and symptom management-
dc.addressDepartment of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto Universityen
dc.addressDepartment of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto Universityen
dc.addressPalliative and Supportive Care Division, Seirei Mikatahara General Hospitalen
dc.addressDepartment of Pharmacoepidemiology, Graduate School of Medicine and Public Health, Kyoto Universityen
dcterms.accessRightsopen access-
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